MEDICARE: D'ORSAY D BRYANT III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	N8197	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13356000000	OTHER	AR	QUALCHOICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609813401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	D'ORSAY D BRYANT III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 295
Second Line	:
City	:	LOCKESBURG
State	:	AR
Zip	:	71846-0295
Country	:	US
Telephone Number	:	870-289-5865
Fax Number	:	870-289-6993

Provider Business Practice Location Address
First Line	:	619 THOMPSON AVE
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4557
Country	:	US
Telephone Number	:	870-863-3122
Fax Number	:	870-863-9377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	02/09/2010

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